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Diseases

Bowel-First Approach Shows Promise in Treating Intra-Abdominal Penetrating Crohn's Disease

Strategic Insights

— 2 min read

A recent study published in BMC Surgery has shed light on the effectiveness of the bowel-first approach in treating intra-abdominal penetrating Crohn's disease. Researchers from Zhejiang University conducted a retrospective cohort study of adult patients with penetrating CD who underwent elective intestinal resection between January 2019 and December 2022. The study found that the bowel-first approach is a safe and feasible alternative to conventional surgery, significantly reducing bowel resection and anastomosis time without increasing operative risk or length of hospital stay.

Key Takeaways:

  • The bowel-first approach is a safe and feasible alternative to conventional surgery for intra-abdominal penetrating Crohn's disease.
  • Patients undergoing the bowel-first approach had significantly shorter bowel resection and anastomosis time compared to those undergoing conventional surgery (48.71 minutes vs. 65.81 minutes, P < 0.05).
  • The bowel-first approach did not significantly increase operative risk or length of hospital stay.
  • Further prospective studies are warranted to confirm the effectiveness of the bowel-first approach in treating intra-abdominal penetrating Crohn's disease.
  • The study included 122 patients, with 31 patients in each group after propensity score matching.
  • The primary outcomes were overall and major postoperative complication rates, while secondary outcomes included total operative time, bowel resection and anastomosis time, intraoperative blood loss, and length of postoperative hospital stay.
  • The research was conducted by Weilin Qi and colleagues from the Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University.

Statistics:

  • 122 patients were included in the study, with 91 patients undergoing conventional surgery and 31 patients undergoing the bowel-first approach.
  • 31 patients remained in each group after propensity score matching, with balanced baseline characteristics.
  • The bowel-first approach significantly reduced bowel resection and anastomosis time (48.71 minutes vs. 65.81 minutes, P < 0.05).
  • The operative times were comparable between the bowel-first and conventional groups (211.13 minutes vs. 239.39 minutes, P = 0.077).

Sources:

  • Qi, W., et al. (2025). Safety and feasibility of the bowel-first versus conventional approach in intra-abdominal penetrating Crohn's disease: a propensity score-matched study. BMC Surgery, 25(1), 1-7. doi: 10.1186/s12893-025-03190-3.
  • Zhejiang University, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine.
  • BMC Surgery. (n.d.). Retrieved from http://bmcsurg.biomedcentral.com
  • NewsRx. (2025, October 26). Researchers from Zhejiang University Publish Findings in Crohn's Disease (Safety and feasibility of the bowel-first versus conventional approach in intra-abdominal penetrating Crohn's disease: a propensity score-matched study). Medical Devices & Surgical Technology Week, 1941.

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